Correlating SPECT-CT activity in cervical facet joints with positive response to cervical medial branch blocks.

Introduction: Cervical facet arthritis is a significant source of neck pain and impaired function that is amenable to treatment with medial branch radiofrequency neurotomy (RFN). Identifying appropriate patients for this treatment requires integration of information from the history, physical exam and diagnostic imaging, but the current diagnostic standard for facet-mediated pain is positive comparative medial branch blockade (MBB). SPECT-CT has recently been evaluated as a potential predictor of positive medial branch blocks with mixed results.

Correlating SPECT-CT activity in lumbar facet joints with response to lumbar medial branch and L5 dorsal ramus blocks.

Introduction: Lumbar facet arthritis is a significant source of back pain and impaired function that is amenable to treatment with medial branch radiofrequency neurotomy (RFN). Identifying appropriate patients for this treatment requires integration of information from the history, physical exam, and diagnostic imaging, but the current diagnostic standard for facet-mediated pain is positive comparative medial branch blocks (MBBs). Lumbar SPECT-CT has recently been evaluated as a potential predictor of positive MBBs with mixed results.

SPECT-CT as a Predictor of Pain Generators in Patients Undergoing Intra-Articular Injections for Chronic Neck and Back Pain.

Background: The ability to accurately predict pain generators for chronic neck and back pain remains elusive.

Objective: We evaluated whether injections targeted at foci with uptake on single-photon emission computerized tomography-computed tomography (SPECT-CT) were associated with improved outcomes in patients with chronic neck and back pain.

Methods: A retrospective review was completed on patients undergoing SPECT-CT for chronic neck and back pain between 2016 and 2020 at a tertiary academic center.

Psychometric Properties of the Multidimensional Impression of Change in a Cohort of Pediatric Patients With Pain.

Objectives: This study assessed the utility of the Multidimensional Patient Impression of Change (MPIC) questionnaire in a pediatric pain population after interdisciplinary treatment.

Design: Observational study with retrospective chart review. The observed treatment program included psychological counseling, relaxation training, physical therapy, occupational therapy, and physician management.

Structural MRI Analysis of Chronic Pain Patients Following Interdisciplinary Treatment Shows Changes in Brain Volume and Opiate-Dependent Reorganization of the Amygdala and Hippocampus.

Objective: The present study examined pre- to post-treatment changes in volumes for brain structures known to be associated with pain processing (thalamus, caudate, putamen, pallidum, hippocampus, amygdala, and accumbens) following an interdisciplinary pain management program.

Design: Twenty-one patients participating in a four-week interdisciplinary pain management program completed the study. The program consisted of individual and group therapies with the following disciplines: physical therapy, occupational therapy, pain psychology, biofeedback/relaxation training, nursing lectures, and medical management.

Multidimensional Patient Impression of Change Following Interdisciplinary Pain Management.

Objectives: To assess patient impression of change following interdisciplinary pain management utilizing a newly developed Multidimensional Patient Impression of Change (MPIC) questionnaire.

Methods: A heterogeneous group of chronic pain patients (N = 601) participated in an interdisciplinary treatment program. Programs included individual and group therapies (pain psychology, physical therapy, occupational therapy, relaxation training/biofeedback, aerobic conditioning, patient education and medical management).

The Relationship Between Body Mass Index and Fluoroscopy Time During Intraarticular Hip Injection: A Multicenter Cohort Study.

Background: Higher body mass index (BMI) is associated with difficulty in obtaining imaging studies. While there is a small body of literature regarding the relationship between fluoroscopy time and BMI during injections for pain management, this has not been studied for intraarticular (IA) hip injections. Further, in academic training centers, trainee involvement may affect this relationship.

Assessing and Treating Patients With Neuropathic Pain.

Neuropathic pain (NP) is a significant source of suffering, disability, and impairment, as well as an enormous cost to society. Historically, pharmacologic treatment has been limited to drugs approved for other conditions, including anticonvulsants, antidepressants, antiarrhythmics, and opioids, but in the past 2 decades several drugs have been approved by the Food and Drug Administration specifically for NP. Understanding the underlying pathophysiology and clinical presentation of the various causes of NP states facilitates a rational selection of pharmacologic, interventional, rehabilitative, and psychological options for reducing pain and maximizing function.

Short-term efficacy of sacroiliac joint corticosteroid injection based on arthrographic contrast patterns.

Objective: To determine the relationship between sacroiliac joint (SIJ) contrast dispersal patterns during SIJ corticosteroid injection and pain relief at 2 and 8 weeks after the procedure. The association between the number of positive provocative SIJ physical examination maneuvers (minimum of one in all patients undergoing SIJ injection) and the patient's response to the intervention was also assessed.

Design: Retrospective chart review.

Successful treatment of athletic pubalgia in a lacrosse player with ultrasound-guided needle tenotomy and platelet-rich plasma injection: a case report.

Athletic pubalgia is a syndrome of persistent groin pain due to chronic repetitive trauma or stress involving the pelvic joints and many musculotendinous structures that cross the anterior pelvis. As a result, the differential diagnosis can be complex, but insertional tendinopathies are the most common. This case report describes a novel approach to the treatment of distal rectus abdominis tendinopathies with ultrasound-guided needle tenotomy and platelet-rich plasma (PRP) injection.

A semi-degradable composite scaffold for articular cartilage defects.

Few options exist to replace or repair damaged articular cartilage. The optimal solution that has been suggested is a scaffold that can carry load and integrate with surrounding tissues; but such a construct has thus far been elusive. The objectives of this study were to manufacture and characterize a nondegradable hydrated scaffold.

A new technique to measure the dynamic contact pressures on the Tibial Plateau.

Studies of the load transfer role of the meniscus have been limited to static experimental and analytical approaches. The objective of this study was to develop an experimental technique to allow the contact pressures on the tibial plateau of cadaveric knees to be measured under dynamic physiological loads. Accordingly, we adapted a load-controlled knee joint simulator to accept a cadaveric sheep knee, programmed the simulator with sheep gait kinematics data, and utilized a pressure sensor array to measure the contact pressure distribution on the lateral tibial plateau during gait.